What is a pre-diagnostic screening for autism?

A pre-diagnostic screening for autism helps to assess whether a child is showing any initial markers or signs of autism, developmental delays, or other disorders. Depending on the concerns of the parent or behaviors a child is demonstrating, a pediatrician may recommend one or more developmental screenings before referring families to full neuropsychological testing (or a diagnostic evaluation). Children who might be considered a higher risk for autism (e.g., children with a sibling with autism) may also participate in screenings to either gain more information about the child’s development.

Examples of the types of screenings include:

Developmental milestones assessment: Children with autism often present with developmental delays from a young age. A developmental milestones assessment allows a pediatrician to check whether or not a child is meeting their milestones at the appropriate age and ask parents questions to gage their social development at home. This assessment can include questions about how many words a child has, communication skills for expressing their wants and needs to others, and behavior patterns and interests in relation to their peers. Pediatricians will also be looking for specific deficits or difficulties in development that are common in children with autism, such as:

  • Lack of eye contact
  • Being unresponsive to one’s name
  • Lack of imitation skills
  • Challenges with (or lack of interest in) pretend play
  • Delays in language development

Hearing test: Providing a hearing test can help rule out some of the symptoms of hearing loss that are occasionally attributed to possible autism, especially in very young children. Sometimes when a child is having trouble reacting and responding to sounds and language in their environment it can indicate some hearing loss or blockage in the ears. In these cases, a pediatrician may recommend a comprehensive hearing test to check for any auditory loss or deafness, before recommending a family look into a diagnostic evaluation.

Speech and language assessment: A speech and language screening is given by a speech-language pathologist (SLP) and used to determine if a child has any expressive and/or receptive language disorders that could be contributing to their speech delay. If a parent’s concerns are mainly language-based rather than behavior-based, a pediatrician may refer the family to an SLP to rule out any other possible causes for their language difficulty. An SLP may screen a child for concerns in the following areas of speech-language communication:

  • Language: including a child’s ability to express themself through spoken language as well as understand and interpret the spoken language of others. This also includes nonverbal communication such as gestures.
  • Speech: including difficulty with the formation and articulation of speech sounds, as well as motor speech disorders. 
  • Social communication: including a child’s ability to use eye-contact, initiate communication with others, use and interpret facial expressions, and practice the correct use of stress and intonation during conversation. 
  • Feeding and swallowing: Depending on the child’s age and oral motor ability, an SLP may decide to assess them for feeding and swallowing. Children with feeding and swallowing disorders may present difficulty chewing, sucking, or swallowing. Some children may demonstrate food or oral aversions. 

If there is still concern about the child’s development after the pre-diagnostic screenings, then a pediatrician can recommend that the family move forward with having their child assessed for autism. This assessment is done through a diagnostic evaluation which can provide the official autism diagnosis and treatment recommendations. 

Do you have questions about pre-diagnostic screenings or your child’s development? Contact the Goldman Center team to speak with a specialist who can answer all of your questions! (773) 998-8500



"Trastorno del espectro autista: Evaluación". Trastorno del Espectro Autista: Evaluación, ASHA, www.asha.org/PRPSpecificTopic.aspx?folderid=8589935303§ion=Evaluación.

Kacinski, Anna. “8 Things You Should Know about the Diagnostic Evaluation Process for Autism Spectrum Disorder.” Alternative Behavior Strategies, Alternative Behavior Strategies, 30 Oct. 2018, https://alternativebehaviorstrategies.com/8-things-you-should-know-about-the-diagnostic-evaluation-process-for-autism-spectrum-disorder/.